血清胱抑素C检测在新生儿缺氧缺血性脑病肾功能评估的临床应用

目的探讨血清胱抑素C(Cys C)检测在新生儿缺氧缺血性脑病(HIE)肾功能评估中的临床应用。方法HIE组65例,对照组65例,两组均于生后24 h内采集静脉血2 ml,进行血清Cys C、尿素氮(BUN)和肌酐(Scr)检测;HIE组在治疗1周后再次采集静脉血2 ml,进行血清Cys C检测。并将结果进行分析。结果 HIE组的Cys C(2.35±0.28)mg/L,高于对照组的(1.34±0.31)mg/L,差异有统计学意义(P0.01),HIE组BUN和Scr检测结果分别为(5.10±1.36)mmol/L和(51.4±6.3)μmol/L,对照组BUN和Scr检测结果分别为(4.81±1.25)mmol/L和(49.5±5.8)μmol/L,两组相比较,差异无统计学意义(P0.05)。HIE组中轻、中、重度三小组入院时血清Cys C分别为(1.92±0.46)mg/L、(2.39±0.67)mg/L和(3.45±0.86)mg/L,治疗一周后血清Cys C分别为(1.36±0.59)mg/L、(1.84±0.58)mg/L和(3.16±0.71)mg/L,其中轻度和中度HIE小组的Cys C下降较明显,较入院时差异均有统计学意义(P0.01,P0.05)。重度HIE小组的血清Cys C治疗前后差异无统计学意义(P0.05)。结论血清Cys C检测可作为新生儿HIE患儿早期肾功能的评价指标,为早期肾功能损害的诊治提供依据,另外也可用于HIE患儿治疗后肾功能恢复情况的评估。

The clinical application of serum cystatin C for renal function impairment in neonates with hypoxic-ischemic encephalopathy

Objective To investigate the roles of the serum cystatin C （ Cys C） in renal function evaluation of neonatal hypoxic - ischemic encephalopathy （HIE）. Methods Serum Cys C, blood urea nitrogen （BUN） and creatinine （Scr） were detected within 24h after birth, both in HIE group （65 cases） and control group （65 cases）. Serum Cys C was detected and analyzed again in HIE group after one week treatment. Results The serum Cys C levels of HIE group （2.35 ±0.28 mg/L） were significantly higher than control group （ 1.34 ±0.31 tag/L） （ P 〈0.01 ）. BUN and Scr in HIE group were 5.10 ± 1.36 mmol/L and 51.4 ± 6.3 mmol/L, respectively; they were 4.81 ± 1.25 mmol/L and 49.5 ± 5.8 mmol/L re- spectively in control group. We failed to find significant differences between two groups （ P 〉 0.05 ）. The serum Cys C levels of mild, moderate and severe HIE subgroups were 1.92 ±0.46 mg/L, 2.39 ±0.67 mg/L and 3.45±0.86 rag/L, respectively; and they were 1.36 ±0.59 rag/L, 1.84± 0.58 mg/L and 3.16 ± 0.71 mg/L after one week treatment. After treatment, the serum Cys C levels both in mild and moderate HIE subgroups decreased dramatically （ P 〈 0.01 and P 〈 0.05, respectively） ; however, we failed to find significant change in severe HIE subgroup （ P 〉 0. 05 ）. Conclusion The level of serum Cys C might be an early marker to evaluate renal function, early renal damage and recovery in neonatal HIE.